title: [Multiple myeloma superimposed on adult T cell lymphoma].
abstract: A 77 year-old male was admitted to the hospital because of lumbago and M-proteinemia. IgA (kappa) monoclonal protein (8,100 mg/dl) was demonstrated in serum, and Bence Jones protein (kappa) in urine samples. The bone marrow examination showed an increased number of pathological plasma cells (34. 5%). Multiple osteolytic lesions were evident on X-ray films. A diagnosis of multiple myeloma (MM) was made. He had exudative erythematous skin lesions on his back. His serum was positive for antibody to ATLA. A biopsy specimen from the skin lesions showed Pautrier's micro-abscess which were filled with Leu 3a positive T lymphocytes. 159 base pairs of human T cell leukemia virus I (HTLV-I)/pX position was identified from a cutaneous sample utilizing the polymerase chain reaction method. Thus, a diagnosis of MM superimposed on adult T cell lymphoma was made. An extensive search failed to find any cases complicated with these two diseases except a report by Tagawa et al. concerning a patient with ATL who developed IgA (kappa) MM during a five year follow up. Therefore, this is the first reported case of MM superimposed on ATL.
authors.affiliation: Department of Hematology, Tokyo Metropolitan Geriatric Hospital.
authors.forename: H
authors.initials: H
authors.lastname: Abe
authors.forename: S
authors.initials: S
authors.lastname: Kurosawa
authors.forename: M
authors.initials: M
authors.lastname: Kawakami
authors.forename: T
authors.initials: T
authors.lastname: Kumakawa
authors.forename: M
authors.initials: M
authors.lastname: Hirai
authors.forename: H
authors.initials: H
authors.lastname: Tsutsumi
authors.forename: M
authors.initials: M
authors.lastname: Mori
mesh_terms: D000368:Aged; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D016399:Lymphoma, T-Cell / Q000473:pathology*; D008297:Male; D009101:Multiple Myeloma / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*
chemical_list: D007070:Immunoglobulin A